Unknown Individual – Ophthalmology Physician, NPI 1811994825

Unknown Individual is a healthcare provider. based in Grand junction, Colorado. specializing in Ophthalmology Physician. They hold a License No. 46444 (CO). The NPI Number for Unknown Individual is 1811994825

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811994825
Phone
(970) 242-8811
Address
1120 WELLINGTON AVE
Deactivation Date
12 July 2022

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9702428811
Graduation Year
2001 (25 years ago)
PAC ID
5294790879
Group Practice PAC ID
5294827143
Professional Enrollment ID
I20080710000712
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1120, Wellington Avenue, Grand Junction, Mesa County, Colorado, 81501, United States

    SUITE 107

    GRAND JUNCTION, CO 815016129

    Phone: (970) 242-8811

    Fax: (970) 242-8898

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81501)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYCO92012Eye and medical examination for diagnosis and treatment, established patient172128

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294827143View full group profile
NameSpecialtyState
-CO

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1811994825 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Ophthalmology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Grand Junction, Colorado for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1811994825. Always confirm identity and privileges with the practice and licensing boards.

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